Measuring Out-of-pocket payment, catastrophic health expenditure and the related socioeconomic inequality in Peru: A comparison between 2008 and 2017

Akram Hernández-Vásquez, Carlos Rojas-Roque, Rodrigo Vargas-Fernández, Diego Rosselli

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Objectives: Describe out-of-pocket payment (OOP) and the proportion of Peruvian households with catastrophic health expenditure (CHE) and evaluate changes in socioeconomic inequalities in CHE between 2008 and 2017. Methods: We used data from the 2008 and 2017 National Household Surveys on Living and Poverty Conditions (ENAHO in Spanish), which are based on probabilistic stratified, multistage and independent sampling of areas. OOP was converted into constant dollars of 2017. A household with CHE was assumed when the proportion between OOP and payment capacity was .0.40. OOP was described by median and interquartile range while CHE was described by weighted proportions and 95% confidence intervals (CIs). To estimate the socioeconomic inequality in CHE we computed the Erreygers concentration index. Results: The median OOP reduced from 205.8 US dollars to 158.7 US dollars between 2008 and 2017. The proportion of CHE decreased from 4.9% (95% CI, 4.5 to 5.2) in 2008 to 3.7% (95% CI, 3.4 to 4.0) in 2017. Comparison of socioeconomic inequality of CHE showed no differences between 2008 and 2017, except for rural households in which CHE was less concentrated in richer households (p<0.05) and in households located on the rest of the coast, showing an increase in the concentration of CHE in richer households (p<0.05). Conclusions: Although OOP and CHE reduced between 2008 and 2017, there is still socioeconomic inequality in the burden of CHE across different subpopulations. To reverse this situation, access to health resources and health services should be promoted and guaranteed to all populations.

Original languageEnglish
Pages (from-to)266-274
Number of pages9
JournalJournal of Preventive Medicine and Public Health
Volume53
Issue number4
DOIs
StatePublished - Jul 2020

Keywords

  • Financial risk sharing
  • Health expenditure
  • Healthcare disparities
  • Peru
  • Universal health insurance

Fingerprint

Dive into the research topics of 'Measuring Out-of-pocket payment, catastrophic health expenditure and the related socioeconomic inequality in Peru: A comparison between 2008 and 2017'. Together they form a unique fingerprint.

Cite this